Family planning
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Family planning

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    During the 20th century, the hallmark of family planning in the United States has been the ability to achieve desired birth spacing and family size (Figure 1). Fertility decreased as couples chose to have fewer children; concurrently, child mortality declined, people moved from farms to cities, and the age at marriage increased (1). Smaller families and longer birth intervals have contributed to the better health of infants, children, and women, and have improved the social and economic role of women (2,3). Despite high failure rates, traditional methods of fertility control contributed to the decline in family size (4). Modern contraception and reproductive health-care systems that became available later in the century further improved couples' ability to plan their families. Publicly supported family planning services prevent an estimated 1.3 million unintended pregnancies annually (5). This report reviews the history of family planning during the past century; summarizes social, legal, and technologic developments and the impact of family planning services; and discusses the need to ensure continued technologic improvements and access to care.
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